Association Self-Funded Health Benefit Plan Coverage Act; create.

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To: Insurance
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Representatives Turner, Arnold,
Carpenter

HOUSE BILL NO. 1019

AN ACT TO CREATE THE ASSOCIATION SELF-FUNDED HEALTH BENEFIT 1
PLAN COVERAGE ACT; TO DEFINE CERTAIN TERMS; TO AUTHORIZE A 2
PROFESSIONAL OR TRADE ASSOCIATION IN MISSISSIPPI TO PURCHASE 3
HOSPITAL, SURGICAL AND MEDICAL EXPENSE BENEFITS COVERAGE FROM A 4
SELF-FUNDED ASSOCIATION PLAN SUBJECT TO THE JURISDICTION OF 5
ANOTHER STATE INSURANCE DEPARTMENT OR THE FEDERAL GOVERNMENT; TO 6
EXEMPT SUCH PLANS SUBJECT TO THE JURISDICTION OF ANOTHER STATE OR 7
THE FEDERAL GOVERNMENT FROM THE INSURANCE LAWS OF THIS STATE AND 8
REGULATIONS OF THE DEPARTMENT OF INSURANCE UPON DEMONSTRATING TO 9
THE COMMISSIONER OF INSURANCE THAT CERTAIN REQUIREMENTS HAVE BEEN 10
MET; TO REQUIRE WRITTEN NOTICE TO BE PROVIDED TO PLAN PARTICIPANTS 11
AND PROSPECTIVE PURCHASERS THAT THE PLAN IS NOT REGULATED BY 12
MISSISSIPPI LAW; TO AUTHORIZE THE COMMISSIONER TO RETAIN 13
PROFESSIONALS TO ASSIST IN REVIEWING A PLAN'S REQUEST TO BE EXEMPT 14
FROM STATE INSURANCE LAWS AND REGULATIONS; TO REQUIRE SUCH PLANS 15
TO DESIGNATE THE COMMISSIONER AS ITS AGENT FOR SERVICE OF PROCESS 16
IN MISSISSIPPI; TO AUTHORIZE THE COMMISSIONER TO ADOPT RULES AND 17
REGULATIONS TO CARRY OUT THE PROVISIONS OF THE ACT; TO AMEND 18
SECTION 83-5-3, MISSISSIPPI CODE OF 1972, IN CONFORMITY TO THE 19
PROVISIONS OF THIS ACT; AND FOR RELATED PURPOSES. 20
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 21
SECTION 1. Sections 1 through 15 of this act shall be known 22
and may be cited as the "Association Self-Funded Health Benefit 23
Plan Coverage Act." 24
SECTION 2. It is the purpose and intent of the Association 25
Self-Funded Health Benefit Plan Coverage Act to provide additional 26
group health benefit plan coverage options to professional 27
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associations and trade associations located in the State of 28
Mississippi by allowing their members to purchase coverage from 29
self-funded association plans that are subject to the jurisdiction 30
of another state insurance department or the federal government. 31
SECTION 3. As used in this act, the following words and 32
phrases have the meanings provided in this section unless the 33
context clearly indicates otherwise: 34
(a) "Association self-funded health benefit plan" means 35
a self-funded health benefit plan established in its domiciliary 36
jurisdiction for the members of a professional association or 37
trade association to provide group hospital, surgical or medical 38
expense benefits to association members and their employees, 39
including dependents. 40
(b) "Commissioner of Insurance" or "commissioner" means 41
the Commissioner of Insurance of the State of Mississippi. 42
(c) "Fully insured association health benefit plan" 43
means an association health benefit plan that provides group 44
coverage for hospital, surgical or medical expense benefits, all 45
of which are guaranteed under a contract or policy of insurance 46
issued by an insurer authorized to do business in this state. 47
(d) "Professional association" means member employers 48
and individual members who are self-employed and are of the same 49
type of profession, which profession must be recognized by the 50
required licensing agency. "Professional association" includes, 51
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but is not limited to, lawyers, physicians, dentists, accountants 52
and architects. 53
(e) "Trade association" means member employers and 54
individual members who are self-employed and are in the same type 55
of trade, such as plumbers, electricians and any others that are 56
trade designations recognized by the required licensing agency. 57
SECTION 4. (1) Except as otherwise expressly provided in 58
this act, the provisions of Title 83, Mississippi Code of 1972, do 59
not apply to an association self-funded health benefit plan that 60
provides group coverage for hospital, surgical or medical expense 61
benefits if the plan can demonstrate, to the satisfaction of the 62
Commissioner of Insurance, that the plan is subject to the 63
jurisdiction of another state insurance department or the federal 64
government by providing the commissioner with the appropriate 65
certificate, license or written authorization issued by the 66
governmental agency that permits or otherwise qualifies the plan 67
to provide group coverage for hospital, surgical or medical 68
expense benefits. 69
(2) In addition to any other requirements set forth in this 70
act, in order to be eligible to provide association group 71
hospital, surgical or medical expense benefits coverage in this 72
state and to qualify for the exemption from the provisions of 73
Title 83, Mississippi Code of 1972, authorized under subsection 74
(1) of this section, an association self-funded health benefit 75
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plan must demonstrate to the satisfaction of the Commissioner of 76
Insurance the following: 77
(a) That the plan was established in its domiciliary 78
jurisdiction for the members of a professional association or 79
trade association that has been organized and maintained in good 80
faith for a continuous period of no less than three (3) years for 81
purposes other than obtaining or providing insurance; 82
(b) That the plan will provide group coverage in this 83
state only through an association whose members are in the same 84
trade or profession, which association has been organized and 85
maintained in this state in good faith for a continuous period of 86
no less than three (3) years for purposes other than obtaining or 87
providing insurance; 88
(c) That the plan is in compliance with applicable laws 89
in its domiciliary jurisdiction and any applicable requirements 90
under the Employee Retirement Income Security Act of 1974 91
addressing coverage, financial and reserve requirements; 92
(d) That the rates are not inadequate, excessive or 93
unfairly discriminatory and are appropriate for the classes of 94
risks for which they have been computed; 95
(e) That the plan is being operated in accordance with 96
sound actuarial principles and is designed to provide sufficient 97
revenues to pay current and future liabilities; 98
(f) That the plan is neither offered nor advertised to 99
the public generally; 100
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(g) That the plan is required under the laws of its 101
domiciliary jurisdiction to maintain excess insurance with a 102
retention level determined in accordance with sound actuarial 103
principles; 104
(h) That the plan is required under the laws of its 105
domiciliary jurisdiction to establish and maintain appropriate 106
loss reserves determined in accordance with sound actuarial 107
principles; and 108
(i) That the plan is a nonprofit organization. 109
(3) Upon demonstrating to the satisfaction of the 110
commissioner that the association self-funded health benefit plan 111
is in compliance with this act, the plan must be recognized as 112
being exempt from the provisions of Title 83, Mississippi Code of 113
1972, and is not subject to regulation by the Mississippi 114
Department of Insurance. 115
(4) On or before February 15 of each year following the year 116
in which an association self-funded health benefit plan receives 117
an initial exemption under this section from the provisions of 118
Title 83, Mississippi Code of 1972, the plan shall certify to the 119
commissioner that the plan continues to meet the eligibility 120
requirements prescribed in this act. Failure to meet and maintain 121
the eligibility requirements set forth in this act is grounds for 122
denial, suspension or revocation of the plan's exemption from the 123
provisions of Title 83, Mississippi Code of 1972, and the plan's 124
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eligibility to provide group health benefit coverage in this 125
state. 126
SECTION 5. A person who participates in an association 127
self-funded health benefit plan in Mississippi authorized under 128
this act must be provided written notice that the plan is not 129
regulated by the Mississippi Department of Insurance, and every 130
purchaser or prospective purchaser must be provided written notice 131
that the person's benefit plan is not otherwise regulated under 132
the laws of this state. 133
SECTION 6. A purchaser or prospective purchaser of coverage 134
under an association self-funded health benefit plan authorized 135
under this act must be provided written notice that the benefit 136
plan is not covered by the Mississippi Life and Health Insurance 137
Guaranty Association created under Section 83-23-211. 138
SECTION 7. A purchaser or prospective purchaser of coverage 139
under an association self-funded health benefit plan authorized 140
under this act must be provided written notice that neither the 141
costs of the plan, benefits nor the benefit plan are regulated by 142
the Mississippi Department of Insurance. 143
SECTION 8. A person in this state is eligible for coverage 144
under an association self-funded health benefit plan if the 145
individual is either an employee who is covered by an association 146
plan in which the employer is participating or a self-employed 147
individual who is covered by an association plan, including a 148
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dependent of the employee or self-employed individual as defined 149
under the terms of the plan. 150
SECTION 9. This act does not apply to a fully insured 151
association health benefit plan or to an association self-funded 152
health benefit plan that is exempt from state insurance regulation 153
in accordance with the provisions of the Employee Retirement 154
Income Security Act of 1974. 155
SECTION 10. This act does not preclude an association from 156
engaging an insurance producer licensed to sell health insurance 157
in this state for the purposes of reviewing and considering a 158
group health plan offered to an association under this act. 159
SECTION 11. When reviewing an association self-funded health 160
benefit plan's request for a determination by the Commissioner of 161
Insurance whether the plan is exempt from the provisions of Title 162
83, Mississippi Code of 1972, and is authorized to provide group 163
health benefit coverage through a professional or trade 164
association in this state, the commissioner may retain attorneys, 165
actuaries, certified public accountants or other professionals and 166
specialists to assist in completing the review, the reasonable 167
cost of which must be borne by the plan that requested the 168
determination. 169
SECTION 12. A third-party administrator administering an 170
association self-funded health benefit plan in this state must be 171
licensed under Chapter 18, Title 83, Mississippi Code of 1972. 172
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SECTION 13. An association self-funded health benefit plan 173
providing coverage in this state pursuant to this act must 174
designate the commissioner as its agent solely for the purpose of 175
receiving service of legal documents or process, for which a 176
filing fee will be determined by the commissioner. 177
SECTION 14. An order issued by a United States District 178
Court enjoining an association self-funded health benefit plan 179
from operating in one or more states or in a territory or 180
possession of the United States upon finding that the group is in 181
hazardous financial condition or financially impaired condition is 182
enforceable in the courts of this state. 183
SECTION 15. The commissioner may adopt such rules and 184
regulations as may be necessary to carry out the provisions of 185
this act. 186
SECTION 16. Section 83-5-3, Mississippi Code of 1972, is 187
amended as follows: 188
83-5-3. (1) Except as otherwise provided in subsection (2) 189
of this section, every insurance company, foreign or domestic, 190
that qualifies to do business in the State of Mississippi shall be 191
required to execute an agreement to be bound by the statute laws 192
of the State of Mississippi pertaining to the periods of 193
limitation prescribed by the statute law of this state. 194
The insurance commissioner is hereby required, as a condition 195
precedent to authorizing any insurance company to qualify and 196
operate under the laws of this state or to do business in this 197
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ST: Association Self-Funded Health Benefit Plan
Coverage Act; create.
state, to require said companies to execute an agreement binding 198
said company to conform to and to be bound and regulated by the 199
statute laws of this jurisdiction as defined in the first 200
paragraph. 201
For purposes of the administration of this section, insurance 202
companies shall consist of all types of insurance companies, both 203
domestic and foreign, that operate in this jurisdiction, including 204
stock companies, mutuals, and fraternal societies and 205
organizations when such fraternal society or organization engages 206
in the insuring of its members or other persons. 207
(2) This section does not apply to an association 208
self-funded health benefit plan exempt from the provisions of 209
Title 83, Mississippi Code of 1972, under Sections 1 through 15 of 210
this act. 211
SECTION 17. This act shall take effect and be in force from 212
and after July 1, 2026. 213